POS1595-HPR INTEGRATION OF TELEMEDICINE AND MEDICAL STUDENTS INTO A NEW DIAGNOSTIC PATHWAY FOR PATIENTS WITH SUSPECTED AxSpA: A QUALITATIVE EXPLORATION OF THE PATIENTS’ EXPERIENCE
Authors: K. Boy, S. May, H. Labinsky, S. Von Rohr, G. Schett, A. Ramming, J. Knitza, F. Muehlensiepen
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Increasing demand and shortage of specialists lead to long waiting times for initial appointments in rheumatology care [1]. These result in diagnostic delays in several rheumatic diseases, with the longest total delay reported for patients with axial spondyloarthritis (axSpA) [1]. Telemedicine, including symptom checkers (SC), capillary self-sampling, and electronic patient-reported outcomes (ePRO) could enable patients to prepare a standardized pre-visit assessment at home. Additionally, fast-track appointments supported by medical students could complement this standardized assessment to enable fast diagnostic assessments and ultimately accelerate start of therapy. <h3>Objectives</h3> This qualitative study was embedded in a clinical trial that investigated a new diagnostic pathway for patients with suspected axSpA, including telehealth tools and fast-track visits supported by medical students. The aim of this qualitative study was to explore patient experiences with this new care model. <h3>Methods</h3> Patients, purposively selected to reflect a heterogeneous sample in terms of age, gender, education and occupation, participated in an explorative, qualitative study using semi-structured phone interviews. Interview data was analyzed using structured qualitative content analysis. <h3>Results</h3> Qualitative interviews were conducted with twenty patients with suspected axSpA (Table 1). Patients perceived the initial consultation supported by students to be equivalent to standard rheumatology care. Patients considered the student consultation to be a valuable option to relieve workforce shortage in rheumatology care. The overall experience with the students was described as holistic and thorough by patients. Some participants pointed out that rheumatic patients often have long medical histories and, thus, may find it difficult to engage with initial care provided lead by students. Patients reported that using SC and performing capillary blood collection helped to better assess their disease status and promote mindfulness in this regard. Some patients described that the SC-questions were unspecific, which led to difficulties answering them. Furthermore, several patients requested a free-text note section to specify their standardized ePRO data. Patients considered the capillary blood collection to be helpful, especially in regard of travel and time savings. Reported disadvantages of self-administered blood collection were uncertainties about the amount of material and the unsustainable packaging material. <h3>Conclusion</h3> Patients perceived the new diagnostic pathway as an efficient and high-quality alternative to standard axSpA-care. Particularly, savings in time and travel were considered favourable by the interviewed patients. Personal comments or chat options could provide an even more individual patient experience. <h3>Reference</h3> [1]Fuchs F, Morf H, Mohn J, Mühlensiepen F, Ignatyev Y, Bohr D, Araujo E, Bergmann C, Simon D, Kleyer A, Vorbrüggen W, Ramming A, Distler JHW, Bartz-Bazzanella P, Schett G, Welcker M, Hueber AJ, Knitza J. Diagnostic delay stages and pre-diagnostic treatment in patients with suspected rheumatic diseases before special care consultation: results of a multicenter-based study. Rheumatol Int. 2022. doi: 10.1007/s00296-022-05223-z <h3>Acknowledgements</h3> This study was partially supported by Novartis Pharma GmbH. <h3>Disclosure of Interests</h3> Katharina Boy: None declared, Susann May: None declared, Hannah Labinsky: None declared, Sophie von Rohr: None declared, Georg Schett: None declared, Andreas Ramming: None declared, Johannes Knitza Grant/research support from: Novartis, Felix Muehlensiepen Speakers bureau: Novartis, Paid instructor for: Novartis, Grant/research support from: Novartis, Abbvie.